title: Peripheral blood monitoring of chronic myeloid leukemia during treatment with imatinib, second-line agents, and beyond.
abstract: BACKGROUND
  The current study was conducted to compare simultaneously obtained bone marrow (BM) cytogenetics (CTG), peripheral blood (PB) and BM fluorescence in situ hybridization (FISH), and quantitative real-time polymerase chain reaction (Q-PCR) for BCR-ABL1 in monitoring response to treatment with tyrosine kinase inhibitors and homoharringtonine (HHT) in patients with chronic myeloid leukemia (CML).
  
  
  METHODS
  PB and BM FISH (n = 112 samples) and/or Q-PCR (n = 132 samples) for BCR-ABL1 were simultaneously obtained in 70 patients with Philadelphia chromosome-positive (Ph+) CML in chronic (68%), accelerated (16%), and blast phase (16%) before the initiation of therapy and during the course of treatment with imatinib (IM) (n = 40 patients), dasatinib (n = 20 patients), nilotinib (n = 4 patients), bosutinib (n = 18 patients), or HHT (n = 4 patients) for patients with newly diagnosed (n = 13 patients), IM-sensitive (n = 34 patients), IM-resistant (n = 30 patients), or IM-intolerant (n = 9 patients) disease. Eighteen patients were found to have Ph+ variants or karyotypic abnormalities in addition to the Ph+.
  
  
  RESULTS
  Excellent correlations (r) were observed between PB and BM FISH (r = 0.95) and PB and BM Q-PCR (r = 0.87), as well as BM CTG and PB FISH (r = 0.89) and PB Q-PCR (r = 0.82). This correlation was not affected by the presence of the Ph+ variant or additional chromosomal abnormalities, the presence of ABL1 kinase domain mutations, phase of the disease, or treatment.
  
  
  CONCLUSIONS
  PB FISH and Q-PCR appear to be reliable methods with which to monitor response to modern therapy in patients with all phases of CML.
authors.affiliation: Department of Hematology and Medial Oncology, Emory University School of Medicine and Winship Cancer Institute of Emory University, Atlanta, Georgia 30322, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Lima
authors.forename: Leon
authors.initials: L
authors.lastname: Bernal-Mizrachi
authors.forename: Debra
authors.initials: D
authors.lastname: Saxe
authors.forename: Karen P
authors.initials: KP
authors.lastname: Mann
authors.forename: Mourad
authors.initials: M
authors.lastname: Tighiouart
authors.forename: Martha
authors.initials: M
authors.lastname: Arellano
authors.forename: Leonard
authors.initials: L
authors.lastname: Heffner
authors.forename: Morgan
authors.initials: M
authors.lastname: McLemore
authors.forename: Amelia
authors.initials: A
authors.lastname: Langston
authors.forename: Elliott
authors.initials: E
authors.lastname: Winton
authors.forename: Hanna Jean
authors.initials: HJ
authors.lastname: Khoury
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001549:Benzamides; D017024:Chemotherapy, Adjuvant; D020732:Cytogenetic Analysis / Q000191:economics / Q000379:methods; D004334:Drug Administration Schedule; D005260:Female; D006403:Hematologic Tests / Q000379:methods; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000191:economics / Q000379:methods; D009367:Neoplasm Staging / Q000191:economics / Q000379:methods; D010879:Piperazines / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction / Q000379:methods; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate